Machine perfusion was conceived of as a way to ameliorate organ preservation long before the full development of clinical transplantation in the 1960s. The University of Wisconsin (UW) solution became the gold standard for cold static preservation in clinical transplantation in the 1980s, while machine perfusion remained a secondary option for organ preservation.
The exponential expansion of clinical transplantation created a greater demand for cadaveric organs since the life-saving organs (e.g., liver, heart, lungs) could not be recovered from live donors. Transplant candidates' waiting times have continued to grow around the world, imposing further morbidity and mortality for this population. Transplant centers have continued to be pushed towards the utilization of expanded criteria organs while the market faces a new supply/demand crisis limited by the current standards in organ preservation. The effective expansion of organ transplantation remains severely limited by cold static preservation with UW solution (or other solutions, such as HTK, CELSIOR, IGL-1, POLYSOL, or VASOSOL solutions), which has not decreased the number of discarded organs. The quality of the organs decreases during the limited amount of time given by cold static preservation (e.g. 4 hours for a heart allograft), since the tissues are unable to function or achieve any degree of regeneration while being kept under severe hypothermia (4° C.) and under anoxic conditions. Meanwhile, the discard rates of human organs have continued to increase in spite the high mortality rate on the transplant waiting lists (18 patients/day) in the United States.
Thus, there is a need to develop improved devices, methods, and preservation solutions in order to improve the success rate of organ transplantation and to decrease discard rates of organs.